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Permit
CITY OF T' G A R D ELECTRICAL PERMIT PERMIT #: ELC2001 -00001 s- �L"�1�'� DEVELOPMENT SERVICES DATE ISSUED: 1/3/01 13125 SW Hall Blvd., Tigard, OR 97223 (503) 639 -4171 PARCEL: 2S101 DD -00401 SITE ADDRESS: 06955 SW SANDBURG ST SUBDIVISION: SALEM FREEWAY SUBDIVISION ZONING: I -P BLOCK: LOT : 001 JURISDICTION: TIG Project Description: Installation of (3) branch circuits for roof top HVAC units. Job No. 21 -001 RESIDENTIAL UNIT TEMP SRVC /FEEDERS MISCELLANEOUS 1000 SF OR LESS: 0 -. 200 amp: PUMP /IRRIGATION: EACH ADD'L 500SF: 201 - 400 amp: SIGN /OUT LINE LTG: LIMITED ENERGY: 401 - 600 amp: SIGNAL /PANEL: MANF HM/ SVC/ FDR: 601 +amps -1000 volts: MINOR LABEL (10): SERVICE /FEEDER BRANCH CIRCUITS ADD'L INSPECTIONS 0 - 200 amp: W /SERVICE OR FEEDER: PER INSPECTION: 201 - 400 amp: 1st W/O SRVC OR FDR: 1 PER HOUR: 401 - 600 amp: EA ADD'L BRNCH CIRC: 2 IN PLANT: 601 - 1000 amp: PLAN REVIEW SECTION 1000+ amp /volt: > =4 RES UNITS: > 600 VOLT NOMINAL: Reconnect only: SVC /FDR >= 225 AMPS: CLASS AREA/SPEC OCC: Owner: Contractor: NORTHWEST MEDICAL TEAMS 3D ELECTRICAL SERVICES INC INTERNATIONAL, INC PO BOX 173 PO BOX 10 OREGON CITY, OR 97045 PORTLAND, OR 97207 Phone: Phone: 503 - 657 -9173 Reg #: ELE 3 -460C LIC 135234 SUP 4478S FEES Required Inspections Type By Date Amount Receipt Wall Cover PRMT CTR 1/3/01 $60.15 2720010000( Elect'I Final 5PCT CTR 1/3/01 $4.81 2720010000( Total $64.96 This Permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable laws. All work will be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more than 180 days. ATTENTION: Oregon law requires you to follow rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR 952 - 001 -0010 through OAR 952 - 001 -0080. You may obtain copies of a rules or direct questions to OUNC at (503) . 246 -1987. tro. 4 PERMITTEE'S SIGNATURE -ALL. f • ISSUE BY: k / aC 42.411,4 2 4 OWNER INSTALLATION ONLY The installation is made on property I own which is not intended for sale, lease, or rent. OWNER'S SIGNATURE: DATE: CONTRACTOR INSTALLATION ONLY SIGNATURE OF SUPR.. E LEC' N: - r o-` DATE: LICENSE NO: 0/7 $ S Call 639 -4175 by 7:00pm for an inspection the next business day 12:29/2000 1_22 F O2BS4T297 _ LITT 01 tigaro -- Electrical Permit Application -moo -ono e--- -- -- s — per, vee: o / -o$ / Nandi no.: Of Tigard G *,0 Peolett/apvl.ao.: Bxpiredate: ' i `o ORS 221 1 H • Rent pcn0.: Cln o�� Address: SW Ball Blvd, Tig llalsia;la �'' Photo: (503) 6394171 .9. Q .. \ A.� $k no.: puymenttype: Load ; C aapproval: , P ;tip ��441,- � l 01 & 2 family dwelling or acaoascry 0 f ommercial/industrial D Mott1 - fam ly 0 Teastt Improvement . Cl New coietra::tiao V Addi iontalteradoalceplaeameat 0 Other: 7 Partial Y o b address: 0, 55 O SAN 0 8v s o— Bids. no.: Suite no.: Tait masltaz lot/eceoant no.: ......---- } 1 lot: Block: � °a' Deccri rioa end location of wait on pm:aim: 72) N V/FC.- UA J J al Projcotasmec Nip Ment CHC. T�� P • Flattmateddais of , ,. , , •• •• _- - .11: I io l (, 0,\, I ' ' I J ti rrl t r , 1 f I I •' ,• I . •i Ill lil'1.1 © . Job gm - o I ,�_ ' a �� aa- Backless name: 3 0 j21c RL Svc't. Lac. -- • .. 1 Address: • • l3, _ .1rat11Ulalbdat i J Stare; D/2 EP: 9 70 8aelta�eild a cc 100 •.Rarteae nom -5 Fax: .SS -7/ o H.maila/voe. . miROse.e. �+of mi�i $1ec btlu.1 e. . >s,itcd 11 , a 1111111111111111 • , . - 8 rr ........, ,onsoaiCretl 0111_ .rPRIM. • ls sIM" 61co a . Lois sosifoesuld ..... . . IIII 8 0 .0 to 01v iced Dees narrttaer • . .; ,„ ANL gems dce1: It I eflAEL i .A/ • laecaatarr 785 apantlwernikeialins 1111 j:, il'1 1'.'1 1 i,‘l �I 1 ?' �,..... t alons Nam /o - / -o/ 201 .,,• s40014=e IM MO r� 401 5 l>r1♦�1�� >~iailal address: ' . Via Sams Z I P : Ow i' , , sopi Iola � l•� Phone: Fax: e 1 i mail: 1 Owner fissallation: Thee installed= is being made on property I own T 1/ - " S which is not intended for solo, lame, mat, or exCLaags accreting to ladabllaa,afewetlegofMogul= 300 once once f 2 0113447, 433, 419.6x10 701. '∎ am to400woo 1 11112 OWaet'9 Si :, • B. TWO" . _ . 401 to O00 own -tow, 1 1 l: f �. 1 111 on exiouloa pet tom:. - Naft16. A. FbeAlr touch dnviir wit. pad= of 2 serda of feeder (as. as ibtaaab dm* Address: - or b, . - •.. .... apt:M Q Staff � ' of onto or feeder to, ai ling h tirade 2 Phan Fax: E•msdi: 1„x.., : •c r. (eI Xeameda 1) . n. w i. 1 , �! . \ Jr : 1 i ; 11 1% ,iJ'1 ,.r rhr cl . ' ,ill il,ar ;,Iilil� i ' ' ' . ' . &abq. of •• eeiondull O. Smite ova 925 1aap + D • IOU, : al, uulhlw i; • tilt 2 (] Somas ever 720 atapraadla of 1b2 0 asaddaakemi a - or or la) c s 1latlat cocoa pos ova final dwr� 6 nas 0 olldlog ova 10,000 Kum Na twit 1 0 Syriano600rnlanominal more t atdcod ar aluniulae aleeratten,orextendon" 0 Building own Lava alofi n 0 Rodeo, 400 0aJp10r moor 0 i7awpm k i n d oveS p000ae 0 Mosif000redanionion o r R V pair god s + f i t m a f l termed= onec dye al i e hi ref de . 'bom J EgialiniablinaUt 0 Wier Per , .....,. I Sabahi MB or rdtb say evt. eftbeab lir el'•: atiglfaa l The shore aro use applsclmie Odor to bamQpo omlr�a seet9m• " p � .,t ,.. $ - -7-1 = 5:-. wolit I die al tae peon toe oons= aeration= no ul it a m en Natieo: This permit appiieelioa Pl alnii f sea (at °') $ Credit a :baet iCaed worn it opartn[tll not abtslae4 State $I1t>rllatge ($%) .._ S eeemt eea *WOW ; / wain d a d o low it has been T OTAL ..�.�*_ accepted as w�upleta Nom er, eta lawn as watt Card S emu. upea. �... r 4404013 (tIMAXXX1 aa 5 �� T 4. Electrical Permit Fees: Limited Energy Fees: .- ' • • . I TY OF WORK INVOLVED RESIDENTIAL ON_ Complete Pee Schedule Below: es) ritiad Energy Foe....„........ ....... ............_.�,......,..,..,. 5.0c teenier or imfpsep r (FOR AU. SYSTEMS) Service included: Items Coat Total Medic Type of wont Involved: Residential • per wet 1000 eq. R trim ` $148.15 4 Audio and Stereo Systems 'each sagging 800 sq. tt. or i a0 1 Burger Alarm porn Meal — $75.00 t lmlraac Brew Egon Mansfd Home or Nodular I SBC.BO 1 0 threw Door 0!osna^ • Dwelilbg emits or Feeder 1 Services or Feeders Heating, Vend,aton and Air Cvrdh8onh0 %stern' i rb aen, Erlangen, or relocation 580.30 2 U Yaouun'Syolern6* 200 0 amps or lase 5108. C 2 t.J 201 amps to 400 gape — 401 amps to 500 amps ----- S240.80 2 I Other ' 601 amp to 1000 anti Over 1000 amps or vfib x•85 2 RsoorelACt Doty : 688.65 2 TYPE OF WORK INVOLVED - COMMERCIAL ONLY Terrpora' � th_n, of Feeders Fos far each system $78.00 :n6l 200 a m or letlon, or nnacat ca+ (SEE OAR 91[- 280.260) 100 amps orlsss �� 888.65 ,•,.,_.. 2 201 amps to 400 amps — 51 —�� 2 ` 'check 'fps ol�'vork involved' 401 asps to 800 amps _ Over600 amps ttb 1000 voile, 0 Addle and Stores Swstama as "V above. Branch Cfecuias [ 1 Boner Conde New, atm:Jon or extenairr, Der panel e) The fee fix branch araib etc* SyOtema Y A M purchase o f s a ' V i w a' j feeder lea 6aehluenan clrwlt 58.85 ...,.e— 2 L..1 Ca O Cats lekuoommunitatlort lnstallat1O b) The tee iv branch drafts amour purebase or sondto 'ire Alarm IrotaGafion First Each banldd on nal branch � 58.89 — __: - . 33,3p -- rr{VAC F�e atlal bOra b./,3 Miscellaneous r1 IAetramentatlon • t(SeMVbo or feeder not ireluded) ; fE8.4� caoh Pump er,mged6n dreg . ∎ 653.40 IMP and Paging Systems Each alpn a one Bgnt7np _ Slgsl drugs) or a led energy r LgndtpE lrnge0on Control' past, albnldon or exyeaia+ --t -- 5 -- moor Loewe (10) I M Medical Each additional Inaptction over the sllowsDle In any of the above ( Nurse Casa Per 1ra'paedOn $62 50 Par hour 582.50 - _.i_.— In Pont 373.78 ❑ Outdoor Landscape Lighting' } Fees: 0 Protect+vs Tangling (.4; is $ to ntsr al of °bora ttaes $ . j 0 O 8% Stets Surcharge $ 4 $ 1 Norte* of Syatatre 2111 Plan Review Pee 3 ` ' Ho Ikon an ere ru ri ed, LtOnnsss Oro rei�u nhd far all or, loess iatorE Jaa '1eFBn Reviav�' ae on r fruit of epP on. Fees: D u s 9 ' Enter total ei above fees S ® Truat Account* 8 °h State Surcharge 6 .r- 1 I Total Balance Due S______ . tAd►Wtoam ek•fecploe 1C/09103 ' CITY OF TIGARD BUILDING INSPECTION DIVISION MST 24= Hc'ir'nspection Line: 639 -4175 Business Line: 639 -4171 T " Dt1P Date Requested J — /d AM PM BLD c i Location 06 C 1S S.54 Suite MEC d P" Contact Person /N/w mul 54UYl Ph / PLM Contractor Ph SWR BUILDING Tenant/Owner 72/494 C Gvt > c / s/1 0 EA ELC /i r - GvlJ�i( Retaining Wall ELR Footing Access: Foundation FPS Ftg Drain SGN Crawl Drain Inspection Notes: Slab SIT Post & Beam Ext Sheath /Shear Int Sheath /Shear Framing Insulation Drywall Nailing Firewall Fire Sprinkler Fire Alarm Susp'd Ceiling Roof Misc: Final PASS PART FAIL PLUMBING • Post & Beam Under Slab Top Out Water Service Sanitary Sewer Rain Drains Final PASS PART FAIL MECHANICAL Post & Beam Rough In Gas Line Smoke Dampers Final PASS PART FAIL CTR Service lC G Rough In UG /Slab / ✓ G C Low Voltage 1.A-►1 t /c Fire Alarm 21:4) PART FAIL SITE Backfill /Grading Sanitary Sewer Storm Drain [ ] Reinspection fee of $ required before next inspection. Pay at City Hall, 13125 SW Hall Blvd Catch Basin Fire Supply Line [ ] Please call for reinspection RE: nable to inspect - no access ADA Approach /Sidewalk Other Date / / _ 70 07/ Inspector Ext Final PASS PART FAIL DO NOT REMOVE this inspection record from the job site.